Provider Demographics
NPI:1386380657
Name:VALLINE, ALEXANDRIA VICTORIA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:VICTORIA
Last Name:VALLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 HOFF RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8537
Mailing Address - Country:US
Mailing Address - Phone:360-914-8285
Mailing Address - Fax:
Practice Address - Street 1:26401 NE RICHARDSON ST
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5030
Practice Address - Country:US
Practice Address - Phone:425-224-6123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health